Laparoscopic Gastric Bypass

Description of the Procedure

Laparoscopy is a procedure in which a tube is inserted through a small incision into the abdomen. Carbon dioxide gas is gently pumped into the abdomen to expand it. A tiny video camera is inserted through the tube, allowing a surgeon to "see" into the abdomen by watching a monitor. Gastric bypass surgery is performed by the surgeon watching the monitor and using very small surgical instruments.

Gastric bypass consists of separating the stomach into two sections using parallel rows of titanium staples, with the staples additionally over-sewn or secured with sutures as needed. The staples remain in place after gastric bypass surgery and provide a permanent division of the stomach. The small upper segment connected to the esophagus remains the functional portion of the stomach, while the larger lower segment connected to the duodenum becomes the bypassed portion of the stomach.

In the next phase of gastric bypass surgery, the surgeon separates a portion of the small intestine and attaches it to the newly created stomach. This section of the intestine is still functional. When the intestine is connected to this small stomach pouch, the opening is about the size of a dime. This allows food to pass directly into the intestine, where it is digested.

Following the connection, the small intestine is then reconnected in the shape of a "Y" (that is why it is called Roux-en-Y). Digestive juices that form in the lower, now non-functional, segment of the stomach and the duodenum will empty into the small intestine at the "Y." Thus, food that enters the small upper stomach pouch will mix with secretions from the lower stomach pouch and duodenum. From here on, digestion and absorption of food nutrients are carried on in a completely normal way.

How Does Gastric Bypass Surgery Work?

After laparoscopic gastric bypass surgery, your small upper stomach will hold about one-fourth cup of food. After eating just a nibble or two, you will feel full, and your appetite will be reduced. This causes weight loss. Although the food you eat is digested, your body cannot get all the nutrients you need. You need vitamin and mineral supplements after gastric bypass to help your surgical wound heal and avoid health problems such as anemia, nerve problems, osteoporosis and others.

On average, patients will lose 120 pounds or about 70 percent of their excess weight in one year following gastric bypass surgery. Some people lose a little more, some a little less. Weight loss will continue during the second year after gastric bypass at a less rapid rate.

About 5 percent of patients will not lose as much weight as they would like with gastric bypass surgery, but will still lose weight. Think of gastric bypass as a tool to help you lose weight and eat healthier foods. Most patients say it is the first time they have stayed on a successful diet that makes them feel good.